“…the developer’s role within an HIA process as one of ensuring feasibility of recommendations, including the financials involved. ‘If there isn’t a connection between the HIA research and potential financial implications, that could be problematic…There needs to be a thoughtful blend between recommendations for health and sustainability and financial implications to the project.’” – ULI and HIAs

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Background

At the start of 2015, CMS began reimbursing Medicare providers under a new billing code, called Chronic Care Management, for care provided remotely and between visits. To use the billing code, CMS required:

Treated patients to have at least two chronic conditions;

The provider to create a comprehensive care plan for the patient; and

Remote care to account for at least 20 minutes of staff time per month.

Proposed Rule Details

The new proposed rule aims to clarify the use of the CCM billing code based on feedback and questions CMS has received (Dolan, MobiHealthNews, 7/2).

Among other things, the proposed rule would require hospitals to:

Have “established relationships” with the patient, meaning provided in-person care within the last 12 months; and